MEDICARE: IRVIN SINGH DMD, MPH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	390200000X	Student in an Organized Health Care Education/Training Program
2	122300000X	Dentist	062866	NY

General Provider Information

NPI Number	:	1225613052
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	IRVIN SINGH DMD, MPH

Provider Business Mailing Address
First Line	:	34 MAPLE RD
Second Line	:
City	:	CHATHAM
State	:	NJ
Zip	:	07928-1112
Country	:	US
Telephone Number	:	727-804-2995
Fax Number	:

Provider Business Practice Location Address
First Line	:	97 E 4TH ST
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10003-9002
Country	:	US
Telephone Number	:	212-292-3848
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/12/2021
Last Update Date	:	12/06/2022

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